scholarly journals Evolving Cardiac Electrical Therapies for Advanced Heart Failure Patients

2021 ◽  
Vol 14 (4) ◽  
Author(s):  
Zain I. Sharif ◽  
Vincent Galand ◽  
William J. Hucker ◽  
Jagmeet P. Singh
Keyword(s):  
Heart Failure ◽  
Cardiac Contractility ◽  
Cardiac Resynchronization ◽  
Cardiac Contractility Modulation ◽  
Carotid Baroreceptor ◽  
Invasive Hemodynamic Monitoring ◽  
The Us ◽  
Baroreceptor Stimulation ◽  
Carotid Baroreceptor Stimulation

Symptomatic heart failure (HF) patients despite optimal medical therapy and advances such as invasive hemodynamic monitoring remain challenging to manage. While cardiac resynchronization therapy remains a highly effective therapy for a subset of HF patients with wide QRS, a majority of symptomatic HF patients are poor candidates for such. Recently, cardiac contractility modulation, neuromodulation based on carotid baroreceptor stimulation, and phrenic nerve stimulation have been approved by the US Food and Drug Administration and are emerging as therapeutic options for symptomatic HF patients. This state-of-the-art review examines the role of these evolving electrical therapies in advanced HF.

The Role of Carotid Baroreceptor Stimulation

2013 ◽  
pp. 137-144
Author(s):  
Guido Grassi ◽  
Gianmaria Brambilla ◽  
Gino Seravalle
Keyword(s):  
Carotid Baroreceptor ◽  
Baroreceptor Stimulation ◽  
Carotid Baroreceptor Stimulation

scholarly journals Cardiac index in atrio- and interventricular delay optimized cardiac resynchronization therapy and cardiac contractility modulation

2015 ◽  
Vol 1 (1) ◽  
pp. 89-91 ◽  
Author(s):  
J. Tumampos ◽  
N. Wulf ◽  
H. Kühnert ◽  
O. Solbrig ◽  
J. Querengässer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Index ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Contractility ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Cardiac Contractility Modulation ◽  
Heart Failure Patients ◽  
Qrs Duration

AbstractCardiac resynchronization therapy (CRT) is an established therapy for heart failure patients and improves quality of life in patients with sinus rhythm, reduced left ventricular ejection fraction (LVEF), left bundle branch block and wide QRS duration. Since approximately sixty percent of heart failure patients have a normal QRS duration they do not benefit or respond to the CRT. Cardiac contractility modulation (CCM) releases nonexcitatoy impulses during the absolute refractory period in order to enhance the strength of the left ventricular contraction. The aim of the investigation was to evaluate differences in cardiac index between optimized and nonoptimized CRT and CCM devices versus standard values. Impedance cardiography, a noninvasive method was used to measure cardiac index (CI), a useful parameter which describes the blood volume during one minutes heart pumps related to the body surface. CRT patients indicate an increase of 39.74 percent and CCM patients an improvement of 21.89 percent more cardiac index with an optimized device.

scholarly journals Possibilities and perspectives of using cardiac contractility modulation in patients with chronic heart failure and atrial fibrillation

Kardiologiia ◽  
2019 ◽  
Vol 59 (2S) ◽  
pp. 4-14
Author(s):  
T. M. Uskach ◽  
S. N. Tereshchenko ◽  
T. A. Pavlenko ◽  
I. V. Zhirov ◽  
O. V. Sapelnikov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Continuous Process ◽  
Cardiac Contractility ◽  
Life Quality ◽  
Cardiac Resynchronization ◽  
Cardiac Contractility Modulation ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Care Problems

Heart failure is one of the main health care problems all over the world. Although, there are many drugs with proven effectiveness and hi-tech devices, there is a continuous process of searching new possibilities in heart failure prophylaxis going on because of huge economic burden and impact on life quality. Developing of atrial fibrillation in heart failure patients increases the risks of hospitalization and all-cause mortality. Appearance of new Optimizer Smart® system of cardiac contractility modulation is a perspective way of treatment in patients with heart failure and atrial fibrillation, who are not a candidate or have not got a good result from cardiac resynchronization therapy (CRT).

scholarly journals Soluble suppression of tumorigenesis-2 (sST2), a new potential biomarker of response to cardiac resynchronization therapy and cardiac contractility modulation in patients with chronic heart failure

2020 ◽  
Vol 49 ◽  
Author(s):  
N. B. Shlevkov ◽  
A. Zh. Gasparyan ◽  
A. A. Zhambeev ◽  
H. F. Salami ◽  
E. V. Guseva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Chronic Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Positive Response ◽  
Cardiac Contractility ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Cardiac Contractility Modulation ◽  
Potential Biomarker

Background: According to numerous studies, from 30% to 50% of patients with chronic heart failure (CHF) are resistant to cardiac resynchronization therapy (CRT) and cardiac contractility modulation (CCM), despite their careful selection in accordance with current guidelines. It is of interest to study neurohormones characterizing myocardial (NT-proBNP) and fibrosis (sST2) as potential additional markers of CHF patients' “response” to CRT and CCM.Aim: To evaluate the potential to use NT-proBNP and sST2 biomarkers in CHF patients combined with transthoracic echocardiography (Echo) and contrast magnetic resonance imaging (MRI) parameters of the heart to predict a  positive response to CRT and CCM devices.Materials and methods: The study included 51 patients (41 men, 10 women) aged 58±12 years (26 to 79 years) with ischemic heart disease post acute myocardial infarction (n=22) or non-ischemic cardiomyopathy (n=29), left ventricle (LV) ejection fraction (EF)<35%, and CHF II–III  NYHA functional class despite≥3 months of optimized medical therapy. The patients were assessed by serum biomarkers NT-proBNP and sST2 measurements, transthoracic Echo, and contrast-enhanced cardiac MRI. After the diagnostic assessment, CRT defibrillators (CRT-D) were implanted to 39 patients and CCM to 12 patients. After prospective follow-up of the patients for 18 to 24 months, predictors of the response to each device type were analyzed in univariate, multivariate, and ROC analysis.Results: The response to CRT-D was found in 21 (54%) patients, to CCM in 7 (58%) patients. Multivariate analysis showed the following predictors of the response of patients to CRT-D were: 1)  sST2<50 ng/mL, 2)  NT-proBNP<3900  pg/mL, 3) <3 LV segments with fibrosis (by MRI) and 4) anteroposterior dimension of the left atrium <4.8 cm (by Echo). Any 2 of these 4 characteristics made it possible to predict the response to CRT with an accuracy of 87% (sensitivity 90%, specificity 83%). The predictors of the response to CCM were: 1)  sST2<30 ng/ml, 2) LV end diastolic diameter <78  mm (Echo), 3) age<56 years, 4) body mass index <27 kg/m2 . Any 2 of these 4 characteristics predicted the positive response to CCM with an accuracy of 92% (sensitivity 86%, specificity 100%).Conclusion: The preoperative sST2 level was the only universal marker of the response to either CRT (< 50 ng/mL) or CCM (< 30 ng/mL) devices in CHF patients with reduced LVEF. The results indicate the potential for improved efficacy of these devices with their earlier implantation after the onset of the heart disease, as well as provided that maximal control CHF in these patients has been achieved.

scholarly journals Cardiac Contractility Modulation Therapy for Heart Failure – First Romanian Experience 

2021 ◽  
Vol 31 (3) ◽  
pp. 609-614
Author(s):  
Diana TINT ◽  
◽  
Sorin MICU ◽  
Keyword(s):  
Heart Failure ◽  
Nyha Class ◽  
Cardiac Contractility ◽  
Case Series ◽  
Cardiac Resynchronization ◽  
Cardiac Contractility Modulation ◽  
Reduced Ejection Fraction ◽  
Cardiac Contractile ◽  
Patients With Heart Failure

Aim: The purpose of this study is to present the first Romanian case-series of patients with heart failure with reduced ejection fraction (HFrEF), supported with the newest generation of cardiac contractility modulation (CCM) device. Methods and results: 16 patients (15 men), aged 66.6±7.49 years, were supported with OPTIMIZER® smart IPG CCMX10 device and followed-up for an average duration of 385.75±326.32 days. The etiology of HF was ischemic in 13 patients (81%), 8 patients (50%) had atrial fibrillation, mean creatinine clearance value was 55.8±13.87 ml/min, and 5 patients (31,2%) had diabetes mellitus. All patients were supported with an implanted cardio verter-defibrillator (ICD), while 5 patients (31.2%) had cardiac resynchronization therapy (CRT) on top. The pharma cological treatment has been optimized in all patients. Six months after implantation, the LVEF has increased from 25.93%±6.21 to 35.5%±4.31 (p=0.00002), NYHA class improved from 3.18±0.4 to 1.83±0.38 (p<0.0001), and exercise tolerance evaluated with 6 minute walking test (6MWT) increased (from 321.87±70.63m to 521.41±86.43m; p<0,00001). Three patients (18,7%) died during the follow-up period after 48, 108 and 545 days (one non-cardiac death). Conclusions: Cardiac contractile therapy is a feasible, safe, and useful therapy for patients with HFrEF whose symptomatology is not improved with optimal standard therapy.

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